A new coalition of fire organizations has emerged that advocates the values and strengths of fire-based EMS systems. Joining to highlight the critical role that the fire service plays in EMS are the Congressional Fire Service Institute (CFSI), International Association of Fire Chiefs (IAFC), International Association of Fire Fighters (IAFF), National Fire Protection Association (NFPA) and National Volunteer Fire Council (NVFC). The formation of the group, "Advocates for Fire Service-Based EMS," is not intended to diminish other EMS systems that are outside the fire service, but to promote all the benefits of fire-based EMS systems.
Leading the charge in June 2006 to form the group was Steve Austin, a long-time veteran of the volunteer fire service and national fire political issues. Austin is past president of the Delaware Volunteer Firemen's Association and the director of governmental relations for the International Association of Arson Investigators (IAAI). He was later joined by Dennis Compton, a 34-year veteran of the fire service who was the fire chief in Mesa, AZ, and assistant fire chief in Phoenix (see page 34).
The formation of the group was in response to several factors. First, in some circles, it has become fashionable to discredit fire service-based-EMS. As an example, a medical doctor in Washington, DC, who sits on the Judiciary Oversight Commission for EMS in that city recently wrote in an e-mail to other commission members, "The truth is fire-based EMS is expensive, inefficient care." His biased comments cannot be supported with any studies or scientific evidence — only his personal opinion.
Other issues that have cropped up lately include an academic paper issued by George Washington University last year that was circulated within the Washington Beltway that implied that third-service, private and hospital-based EMS programs are the proper ways to design an EMS system.
Another issue that prompted the five prominent fire organizations to join together included the Institute of Medicine's report last year detailing problems with EMS and the emergency system in the U.S. The fire service was hardly mentioned in the report, although the fire service continues to be the largest provider of emergency medical care in the country.
Other issues that prompted the group to form included the advocacy by some for a newly formed federal agency called the "United States EMS Administration," the attempt to formulate an EMS congressional caucus similar to the fire caucus, and the lack of fire service representation at important meetings and other sessions.
In recent years, there has been a strong push by EMS organizations outside the fire service to secure federal fire service grant funds. Before 2000, the entire distribution of federal funding to the fire service amounted to about $48 million while police organizations were receiving typically over $1 billion a year. Since then, the fire service has seen funding of approximately $5 billion. Now that federal dollars are starting to flow into the fire service, non-fire-based EMS organizations are stepping forward, including private ambulance companies and others who want a piece of that pie. These non-fire-based EMS organizations were successful through legislation last year to mandate that 2% of the FIRE Act grant money would go to non-fire-based EMS organizations. This year, they have succeeded in getting their supporters in Congress to introduce legislation outlining that 10% of the FIRE Act grant money should go to non-fire-based EMS organizations. That legislation has not passed, but this session of Congress is not yet over. The fire service is not opposed to these non-fire-based EMS systems obtaining federal money, but they should get it somewhere else.
To support their mission, the Advocates for Fire Service-Based EMS have released a white paper, Prehospital 911 Emergency Medical Response: The Role of the United States Fire Service in Delivery and Coordination. Authors and contributors include Dr. Frank Pratt, medical director for the Los Angeles County Fire Department; Dr. Steven Katz, associate medical director for Palm Beach County, FL, Fire Rescue; and Dr. Paul Pepe, director for the City of Dallas Emergency Medical Services. The white paper is intended to help fire service organizations educate local, state and federal officials about the key and pivotal role the fire service plays in the delivery of EMS. As Dennis Compton said, "What this white paper represents is an awareness that EMS begins the second a 911 call is placed and highly skilled and trained emergency medical personnel from the local fire department are dispatched to the scene to provide the first level of care to victims."
The Advocates for Fire Service-Based EMS have produced a video, "Fire Service-Based EMS: The Right Response." The video complements the white paper and features highly respected fire service-based advocates who espouse the benefits of the fire service delivery of emergency medical care. It can be obtained by submitting a request to [email protected].
GARY LUDWIG, MS, EMT-P, a Firehouse® contributing editor, is a deputy fire chief with the Memphis, TN, Fire Department. He has 30 years of fire-rescue service experience. Ludwig is chairman of the EMS Section for the International Association of Fire Chiefs (IAFC), has a master's degree in business and management, and is a licensed paramedic. He is a frequent speaker at EMS and fire conferences nationally and internationally, and can be reached through his website at www.garyludwig.com.
